Seven. Point. Five.
Tuesday, October 9, 2012 at 12:41PM 
I've never said the actual number here before. I've never had the nerve to say Arden's A1c is 8.5 and no matter what I do I can't seem to get it to go lower. Back in February when Arden's A1c was at it's lowest point ever, I still couldn't tell you that it was 7.8. We had a .7 reduction in February, the biggest single leap ever, a sign that we had cracked the code and still... I couldn't say the number out loud. As proud as I was of the 7.8, I couldn't bear the thought of you adding .7 to it and realizing that her A1c was 8.5 just three moths prior.
A1c is funny. Everyone tells you not to measure yourself against the number, yet it's the only number that we measure to examine the job we are doing managing type I. I understand why I shouldn't measure myself, but if not with this, how? How do I know if we are doing okay, better, worse?
I tried, just as I always do, to not think about what Arden's A1c was going to be as we walked into her Endo appointment yesterday. I was doing a good job too because I was so focused on the fact that Arden was filling out the pre-visit form on her own for the first time. It made me think back to the first time we brought her to this office, she was two years old and this whole thing seemed like a bad dream. In those days the A1c results made me nauseas. One time, back when the tests took much longer, our NP caught me in the lobby as we were leaving to say that Arden's A1c dropped .2 to 8.7. I cried right there in the lobby when I heard the news and the NP hugged me because I was so inconsolable, so happy, eminently relieved.
I cried because each point felt like more life, like better days. Forget the notion that we are doing something right or not, I just want Arden to live as long and as healthy a life as possible. Ironically, I want the same thing for all of the people that I love and I'm probably making far worse life choices for myself and others then I do for Arden. Diabetes is the catalyst that makes me pay attention to this degree, it is a curse and a blessing in many ways, this is one of them. Now it's six years later, Arden isn't two, and I'm not new to this diabetes thing. "It does get better", I thought as I watched her write her name on the form. Maybe not easier, but better.
You'll get better, I got better, good things are coming.
So yesterday when the NP told me that Arden's A1c was 7.5. I just smiled and said, "great". Sure my eyes tried to fill up a time or two as she praised Arden for her hard work. I was so proud of Arden that I didn't have time to make the connection between the number and Arden's health. I never thought of it like it meant more days, no arbitrary feelings that we did something monumental or did something that meant the literal difference between having a tomorrow and not. It just felt like an accomplishment, no different then if I had completed an exercise goal or written a blog post. I set out to do something and got a good result. Simple. If next time doesn't go our way, then we try again much like hitting a baseball. Just because you don't always get the result you desire doesn't mean that your approach is wrong, only that you are doing something that has so many variables that it is not reasonably within your control. Your job is to win the ones that you can and not let the others slow you down.
I think I'm finally past the part where I think of diabetes so fu@&ing literally ever second. Yesterday, I felt happy, not relived, not like I just pulled Arden from the jaws of certain death, just happy. I think one day, if you already don't, you'll feel the exact same way because it gets better.
It was a long road from 9s to 7.5 and we aren't finished yet. The NP asked me what my short-term A1c goal was and I said with some confidence that I think I can get it to 7.1. I've identified two times of day with CGM graphs where I think we can do a better job of pre-bolusing and making better food choices. Those changes should move the number toward 7.1. I'm going to start by trying to effect those moments and see where we are in three months. I'll strike out once and a while, but I bet that by the time another three months goes by, I'll have more hits then outs. This is how, in my opinion, you should measure yourself. Simply by being able to say that you are trying with every ounce of who you are. By understanding that you aren't trying to win and that it's not possible for you to lose. As long as you don't give up, you're doing perfect!
I want to take a moment to list a few of the factors that I believe have the biggest influence on Arden's A1c results. When the NP asked me what my secret was I flippantly said, "Apidra, DexCom and not sleeping", but there is more to it then that.
Support - Love and support from family, friends and teachers is huge.
Insulin Pump - Being able to give insulin quickly and unobtrusively for meals, snacks and high BGs.
CGM - Arden's DexCom is a window to the past, present and future of her BGs and I couldn't make the pinpoint adjustments that helped us get to this new level without it. It's sad to me each day that the FDA doesn't approve it's use for young people.
Over night monitoring - Arden is sleeping almost half of each day, if you can control the night then a few bumps during the day don't hit the A1c average so hard.
Apidra - Arden's BGs are move stable on Apidra then they ever were with the other insulin she was using in the past. Make sure you are using the insulin that works best for you... not just the one some sales person gave your doc.
D.O.C. - You all give me strength to do these things when I otherwise feel like I can't. It's knowing that one of you is awake, sad, crying, happy or running around out of your mind like me that makes me realize that I'm doing okay.
As we walked through the lobby yesterday on the way to our car we saw a teenage girl filling out the same form that Arden had just written her name on one hour before. This girl was just on the verge of being a woman and that almost made me cry... but it didn't have anything to do with type I diabetes. It does go so fast, just like they say.
Arden's A1c is Seven. Point. Five!
A1C, Apidra, DexCom, OmniPod, Transparency in Daddy's Blog, DexCom Blog, OmniPod Blog
Reader Comments (13)
Congrats, Scott. :) (and Arden)
The A1C is awesome, but what is even awesomner is that ARDEN is filling out her own forms at the doctor's office! It is so important to involve children in their diabetes care, because one day you're not going to be there to walk them through this all. I personally think that all children and teens with T1D should be as responsible as possible for filling out forms, refilling prescriptions, and dealing with insurance. My parents forced me to learn these things at a young age. I resented it for a bit, but was oh-so-greatful when I moved out on my own at 18 and didn't think for a moment that dealing with this mess was at all a barrier! When you're independent, the sky really is the limit.
As a full grown T1D people often ask me how I can be so positive about living with my disease. The answer is easy... kids like Arden! If she can be brave and work so hard to manage this disease then I certainly can. None of us are perfect, (with or without diabetes), but each of us can make small changes and work to get better every day. Arden is. And here's the real secret - it's the journey that makes her successful, not the number. She's building skills that will make her successful not only in her treatment of her diabetes but a long life as well.
You're a great Dad. No matter what her A1C is.
Now that, my friends, is transparency! Thank you Scott, for revealing her A1C. It's about time we stopped measuring ourselves by it, and applaud the fact that we can try to get better with every 3 months that go by. When we hide it, I believe we shame it and it holds power over us. This is the first time I have heard mention of Arden's A1C, not that I was looking for it, but it just strikes me as YEAH, Scott is coming on board the 'we do the best we can with what we have got' train that I try to pull people on.
I am proud of you, I am proud of Arden. Rock on, my friend.
Such great news! Congratulations (to both of you)
THANK YOU for this post! It is just what I needed today! My son has a doctors appt today and I have spent all day dreading it and the A1c results. He was diagnised a year ago on Sept. 22nd and I just feel like the last 3 months have been the hardest so far. Your blog has been such a comfort to me and I am sure so many others...keep up the great work :)
Not quite sure what to say to all of these wonderful responses... It might take me a day to say thank you properly. xoxo
Thanks for sharing! What a wonderful Mom you are and what a beautiful little girl!
KML, I am unbelievable touched that I sound like a mom, as I sort of am, but not so much. My name is Scott and I have been a stay-at-home dad for almost 13 years, I feel like a mom most days for sure. Thank you so much for taking the time to comment... and for the generous words!
My Best,
Scott
Congrats on the A1c to you and Arden!! Any improvement is an achievement but getting it closer to your desired range is even better. Definitely something to be emotional about. It's almost impossible not to judge ourselves on this one result but like you wrote, there is so much more to it. Keep up the good work :)
Great job!
We have really struggled with our A1c. It makes me feel like a fraud sometimes because people look to me for answers and advice. I think that's why I made it perfectly clear in the first few paragraphs of my book that I am not the person who can help you drop a full point.
(But I am the person who can help you swag for birthday cupcakes!)
Thanks for sharing your past and present A1c's. It really helps to make others feel like they aren't alone in this struggle.
Hey everyone!
So a long time ago I realized that I was sharing more of the 'good stuff' then the bad. I didn't figure this until one of my readers told me that sometimes my blog made her feel bad about the job she was doing - that certainly wasn't why I was writing Arden's Day so I asked her why. It was her response that pushed me further into the world of transparent blogging then I had ever been before. It was her response that allowed me to write so openly in my upcoming book (wait till you see how honest). In the end, what's the point of doing all of this if it isn't helping people as completely and honestly as possible. What's the point of almost sharing, partially helping?
So thank you all for the wonderful responses and heartfelt congratulations , but I don't think I deserve any extra accolades. What you are seeing is my progression as a blogger. It's really no different then the journey that we are all taking as we learn and grow with diabetes. Just taking our past experiences and building a new understanding with them. Then I share what I've learned and hopefully someone is helped. Simple.
You all rock!
Scott